AB0680 Non ophtalmological neurologic ischaemic manifestations of giant cell arteritis. (12th June 2018)

• Record Type: Journal Article
• Authors: Coronel Tarancón, L.; Monjo, I.; Fernández, E.; Balsa, A.; De Miguel, E.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1483
• Page End: 1483
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.5775
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Giant cell arteritis (GCA) is a very infrequent cause of stroke. It is diagnosed in 0.15% of brain infarctions. On the other hand, in scientifical literature there are very little patients with ischaemic brain infarctions that describes stroke as the clinical presentation of GCA. It might suggest that it is a underdiagnosed condition. Objectives: To check the frequency of stroke as presentation symptom of GCA and other findings related with it. Methods: Retrospective observational study of 123 consecutive patients diagnosed of GCA in our hospital. We reviewed the past medical history to obtain sings, symptoms and ultrasound parameters of the first medical evaluation. We searched for: age, sex, hypertension, diabetes, dyslipidemia, anterior ischaemic optic neuropathy (AION), headache, visual disturbances, Polymyalgia Rheumatica (PMR), jaw claudication, general symptoms, non oftalmological brain ischaemic symptoms, disease outbreak and laboratory test: erythrocyte sedimentation rate (ESR), C reactive protein (CRP), Haemoglobin (Hb). For the analysis we divided the sample into two groups: a). Neurological symptomps b). Other presentations. For statistical comparisons, we used SPSS version 17.0. Descriptive analysis and comparison was performed of the two groups. X 2 was used for qualitative values and means comparisons for quantitative. Results: Of our 123 patient's cohort: 37 patients (30.08%) suffered from ischaemic events of the internal carotid artery, 25 patients (20.32%) of AION and 12 patients (9.8%) presented with neurological symptoms different from AION. Out of the 12 patients with non ocular ischaemic symtomps of the central nervous system: 5 (44.66%) were diagnosed of transitory ischaemic accident (TIA), 4 (33.33%) of stroke, 2 (16.66%) of VI cranial nerve paresis, one the patients that presented with III and VI par paresis suffered also from TIA, at last, one patient presented ischaemic phenomena related with small-vessels vasculitis and one patient with dizziness due to cerebellum affectation. Clinical and analytical data are presented in the table: No patient was presented with PMR or jaw claudication. 3 (25%) patients died during the follow up in the neurologic symptoms group in comparison with 11 (9.90%) of the non neurological (p 0.11). Conclusions: Stroke is not a rare form of presentation of GCA and should be suspected in all ischaemic brain events that are associated with high acute phase reactants in elderly patients. It is important to identify these patients due to the severity of the disease and the possibility of specific treatment that may avoid new events. References: [1] Roaa S. Alsolaimani, et al. Severe intracraneal involvement in Giant Cell Arteritis: 5 Cases and literature Review. J Rheumatol2016; 4 3:3. Disclosure of Interest: None declared